5165.34
[Renumbered from 5111.331] Payments made to reserve bed during temporary absence.

(A)
The department of medicaid may make medicaid payments to a nursing
facility provider under this
chapter to reserve a bed for a recipient during a temporary absence under
conditions prescribed by the department, to include hospitalization for an
acute condition, visits with relatives and friends, and participation in
therapeutic programs outside the facility, when the resident's plan of care
provides for such absence and federal financial
participation for the payments is available.

(B)
The maximum period for which payments may be made to reserve a bed in a nursing
facility shall not exceed thirty days in a calendar year.

(C)
The department shall establish the per medicaid day
payment rates for reserving beds under this section. In
establishing the per medicaid day payment rates, the department shall

set the
per medicaid
day payment rate at an amount equal to the following:

(1)
In the case of a
nursing facility that had an occupancy rate exceeding ninety-five per cent, an amount not
exceeding fifty per cent of the per medicaid day payment rate the provider would be
paid if the recipient were not absent from the nursing facility that
day;

(2)
In the case of a
nursing facility that had an occupancy rate not exceeding ninety-five per cent, an amount
not exceeding eighteen per cent of the per medicaid day
payment rate the provider would be paid if the recipient were not absent
from the nursing facility that day.

(D)
For the purpose of setting a nursing facility's per
medicaid day payment rate to reserve a bed for a day during the period
beginning on the effective date of this amendment and ending December 31, 2013,
the department shall determine the nursing facility's occupancy rate by using
information reported on the nursing facility's cost report for calendar year
2012. For the purpose of setting a nursing facility's per medicaid day payment
rate to reserve a bed for January 1, 2014, or thereafter, the department shall
determine the nursing facility's occupancy rate by using information reported
on the nursing facility's cost report for the calendar year preceding the
fiscal year in which the reservation falls.